Provider Demographics
NPI:1235425299
Name:WEISMAN, ERRIN (DO)
Entity type:Individual
Prefix:
First Name:ERRIN
Middle Name:
Last Name:WEISMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ERRIN
Other - Middle Name:
Other - Last Name:MORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:OTWELL
Mailing Address - State:IN
Mailing Address - Zip Code:47564-0029
Mailing Address - Country:US
Mailing Address - Phone:812-441-4290
Mailing Address - Fax:727-436-3051
Practice Address - Street 1:714 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47567-1231
Practice Address - Country:US
Practice Address - Phone:812-441-4290
Practice Address - Fax:727-436-3051
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004107A207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine